Marwaan Macan-Markar
PHUKET, Nov 29 2006 (IPS) – The approaching Christmas has brought a rare sparkle to the eyes of a 45-year-old Thai mother coping with the stigma of being infected with HIV. She smiles as she snips away with a pair of scissors, shaping paper for a decorative ball.
Sitting around a table and engaged in similar activity are three other Thai mothers, also infected with the virus that triggers auto-immune deficiency syndrome (AIDS).
In all, there are 22 women residing at the Life Home Project, located in the main town of this resort island, churning out Christmas decorations in an effort to engage with the world beyond the one-storey building that serves as their haven. Major hotels along the popular beach at Patong, a 30-minute drive from the town centre, are among the project s clients.
Such helpful bonds disappear when these women step out on to the narrow streets for simple tasks such as buying groceries or getting a haircut. People don t serve us. They turn us away, said the woman who did not reveal her name. People in the town give us strange looks because some of us have skin lesions on our arms and faces.
At times these women, and the 20 children living in the shelter, have faced similar discrimination in public institutions, too, such as the main government hospital or schools. They are kept waiting longer than others when they go to the hospital, says Penappa Wuttimanoop, manager of the home. They feel discriminated by the way the nurses keep a distance from them.
Yet, few who live in the shelter are prepared to concede defeat. It comes from the change this centre has witnessed since it was set up five years ago from being a place where women with HIV came to die to one where they expect to live longer thanks to mitigating drugs that the Thai government provides.
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I feel I have come back to life after moving here. Earlier I felt I was dead because there was no medicine and because of the discrimination in my community, says a 38-year-old mother of four children who was infected by her husband, the mode of infection for most women in the shelter.
Concern over such discrimination faced by people living with HIV in Phuket and its neighbouring provinces of Krabi and Phang-Nga has prompted local and international organisations to mount awareness drives to remove hostility in the local communities. Youth from some of the villages and towns have been roped into one effort in this southern part of Thailand for World AIDS Day, marked on Dec. 1.
Communities and schools must help youth with HIV/AIDS. We also want youth-friendly health services for people with HIV, say Nongnut Kiyawanin, a first year university student from Baan Nai Rai, a village in Phang-Nga. From our experience we know that local health centres treat HIV people very badly. In schools, the children with HIV are humiliated.
People here have still to learn to accept people with HIV as members of their community, Yodying Janchote of the Thai Network for People Living with HIV/AIDS told IPS. Stigma and discrimination are not getting better. Even when we teach people in communities how HIV spreads, it doesn t change views.
He added that such hostile reactions have resulted in two worrying consequences; that people with the killer virus do not admit to their HIV positive status, preferring to remain silent, and also do not go to hospitals for the life-prolonging anti-retroviral drugs.
What prevails in Phuket and other southern provinces reveals a growing anomaly in a country that has been grappling with the killer virus since the early 1980s and has earned wide acclaim for its successes. The discrepancy arises from more attention being paid to the country s northern and north-eastern belts where AIDS has been ravaging communities for a longer period.
It was only seven or eight years ago that we started noticing the spread of HIV in the south. People didn t think of it as a problem in the south for a long time, because the figures were low, says Scott Bamber, HIV/AIDS project officer at the Thai division of the United Nations Children s Fund (UNICEF).
This latent spread of HIV in the south has translated into local communities not accepting people with HIV unlike their counterparts in the north. Recognition of the problem has come late. What happened in the rest of the country is just being discussed in the south, he added in an interview. In the north, communities had to respond because of the many people dying.
What is more, non-governmental organisations (NGOs) that led the HIV prevention campaigns and initiated programmes to address stigma and discrimination over the past two decades have centred their efforts in the northern provinces such as Phayao, Chiang Rai and Lampang. Phayao still ranks as the worst affected region with 90.3 HIV cases for every 100,000 persons in the province, according to health ministry records.
It is only in the past two years, after the tsunami (that devastated the southern coastline in December 2004) that there has been an increase in the number of NGOs working on HIV/AIDS issues, says Bamber. This was not so before.
Estimates as to how much HIV has spread in Phuket vary. A 2004 U.N. report noted that 2.9 percent of Thai women and 4.9 percent of migrant women in the province had the deadly virus, ranking it as among the worst affected areas. But health ministry records say that Phuket has 21.8 cases of HIV for every 100,000 people, ranking it much below the even more worrying northern provinces.
The concerns about the growing HIV rates in Phuket come as Thailand struggles to maintain its good record in battling the virus. The new HIV infection rates for 2005 were close to 18,000, reveals the United Nations Joint Programme on HIV/AIDS (UNAIDS). At its height, in the early 1990s, before Thailand launched prevention campaigns, the country witnessed 140,000 new infections a year.
But UNAIDS officials are warning that the country, which has an estimated 580,000 people living with HIV, is in the danger of becoming complacent about prevention and the need to combat stigma, as evident in Phuket.
The epidemic is evolving. The South in particular is at risk because the old prevention efforts have fallen away, Patrick Brenny, Thailand coordinator for UNIADS, told IPS. Stigma and discrimination are a problem. Forty percent of people living with HIV/AIDS say they are victims of discrimination. That is unacceptable.
